34D2177639 CLIA NUMBER - EC OPCO SOUTHPORT, LP DBA TERRABELLA SOUTHPORT

Laboratory Demographics

  • CLIA Code: 34D2177639
  • Facility Name: EC OPCO SOUTHPORT, LP DBA TERRABELLA SOUTHPORT
  • Facility Address: 1125 E LEONARD STREET
    SOUTHPORT, NC
    ZIP 28461
  • Facility Phone: (910) 454-4001
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: NICHOLE WOOD
  • NPI Number: 1285270876
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 34D2177639
LAB Type Assisted Living Facility
Facility Name EC OPCO SOUTHPORT, LP DBA TERRABELLA SOUTHPORT
Street 1125 E LEONARD STREET
City SOUTHPORT
State NC
ZIP 28461
Phone 9104544001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2026
Certificate Expiration Date 1/14/2028
Facility Type Assisted Living Facility
Lab Director NICHOLE WOOD

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This page was last updated on: 5/18/2026